title: Anti-inflammatory properties of montelukast, a leukotriene receptor antagonist in patients with asthma and nasal polyposis.
abstract: BACKGROUND
  Leukotrienes, especially LTC4, are important inflammatory mediators in allergic and nonallergic inflammation of the entire airways. Of particular interest are numerous theories regarding the pathogenesis of aspirin intolerance with subsequent hyperproduction of leukotrienes and inhibition of cyclooxygenase.
  
  
  OBJECTIVE
  To examine the influence of the cysteinyl-leukotriene receptor antagonist montelukast on clinical symptoms and inflammatory markers in nasal lavage fluid in patients with bronchial asthma and nasal polyps, and determine its dependency on aspirin sensitization.
  
  
  METHODS
  Twenty-four patients (7 women, 17 men; median age, 55.5 years) with nasal polyps and controlled asthma (n=12 with aspirin intolerance) were treated with 10 mg montelukast once daily for 6 weeks in a blinded, placebo-controlled fashion. The placebo phase was randomly assigned 4 weeks before (n=12) or after treatment (n=12). Symptom score, rhinoendoscopy, rhinomanometry, smears for eosinophils, and nasal lavages for the determination of different mediators were performed.
  
  
  RESULTS
  Compared to placebo, there were significant improvements in the nasal symptom score and airflow limitation as well as a reduction in the inflammatory mediators in nasal lavage fluid after treatment. Furthermore, reduced eosinophils in nasal smears and peripheral blood were observed 2 and 6 weeks after treatment.
  
  
  CONCLUSIONS
  Leukotriene 1 receptor blockade led to a significant decrease in eosinophil inflammation accompanied by a reduction in other mediators such as neurokinin A and substance P in the nasal lavage fluid of patients with nasal polyps and asthma, with or without aspirin intolerance.
authors.affiliation: Department of Internal Medicine B-Cardiology, Intensive Care, Pulmonary Medicine and Infectious Diseases, Greifswald, Germany christopher.schaeper@goolgemail.com
authors.forename: C
authors.initials: C
authors.lastname: Schäper
authors.forename: O
authors.initials: O
authors.lastname: Noga
authors.forename: B
authors.initials: B
authors.lastname: Koch
authors.forename: R
authors.initials: R
authors.lastname: Ewert
authors.forename: S B
authors.initials: SB
authors.lastname: Felix
authors.forename: S
authors.initials: S
authors.lastname: Gläser
authors.forename: G
authors.initials: G
authors.lastname: Kunkel
authors.forename: B
authors.initials: B
authors.lastname: Gustavus
mesh_terms: D000085:Acetates / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000627:therapeutic use*; D001249:Asthma / Q000150:complications / Q000188:drug therapy*; D055963:Asthma, Aspirin-Induced / Q000150:complications / Q000188:drug therapy; D002452:Cell Count; D003521:Cyclopropanes; D003545:Cysteine / Q000008:administration & dosage / Q000037:antagonists & inhibitors / Q000627:therapeutic use; D004804:Eosinophils / Q000166:cytology; D005260:Female; D006801:Humans; D020024:Leukotriene Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D015289:Leukotrienes / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017817:Nasal Lavage Fluid / Q000737:chemistry / Q000276:immunology; D009298:Nasal Polyps / Q000150:complications / Q000188:drug therapy*; D015288:Neurokinin A / Q000032:analysis; D011804:Quinolines / Q000008:administration & dosage / Q000627:therapeutic use*; D013373:Substance P / Q000032:analysis; D013440:Sulfides; D016896:Treatment Outcome
chemical_list: D000085:Acetates; D000894:Anti-Inflammatory Agents, Non-Steroidal; D003521:Cyclopropanes; D020024:Leukotriene Antagonists; D015289:Leukotrienes; D011804:Quinolines; D013440:Sulfides; C112381:cysteinyl-leukotriene; D013373:Substance P; D015288:Neurokinin A; D003545:Cysteine; C093875:montelukast